It is in keeping with the peculiar form which shamanism assumes in northwestern California that the doctor and the witch are more clearly separated in the native mind than in the remainder of California.
Disease was caused by the breaking of some observance of magic, perhaps sometimes was thought to occur spontaneously, or was brought on by people who had become kitdonghoi, in Hupa terminology.
These were not shamans of avowed training, but men of secret evil proclivities.
They did not control animate “pains” or spirits, but operated through material objects possessing magic powers.
These objects were also called kitdonghoi.
A favorite instrument was a bow made of a human rib with a cord of wrist sinews.
From this, after the proper mythic formula had been recited — the Hupa or Yurok can imagine nothing of real consequence being done successfully without a formula — a mysterious little arrow was shot which caused almost certain death.
These devices, or the knowledge of them, were secretly bought by resentful and malicious people from men suspected of possessing the unnatural powers.
The kitdonghoi might sometimes be seen at night as something rushing about and throwing out sparks.
His instrument enabled him to travel at enormous speed, and to turn himself into a wolf or bear in his journeys.
This is the only faint suggestion in northwestern California of the bear shaman beliefs that are so prevalent everywhere to the south.

It is evident that the northwesterner distinguishes black magic and curative doctoring rather plainly — much as superstitious Europeans might, in fact.
The central and southern Californian, it will be seen hereafter, deals essentially in undifferentiated shamanism, which can be equally beneficent or evil.
This contrast is connected with several peculiarities of northwestern culture.
The Yurok and Hupa are far more addicted to magic in the narrower sense of the word, especially imitative magic, than the unsophisticated central Californians.
The formulas with which they meet all crises rest essentially on this concept; and there are literally hundreds if not thousands of things that are constantly done or not done in everyday life from some motive colored by ideas that are imitatively magical
Though the world is full of deities and spirits, these also are approached by the avenue of magic, by the performance of an action which they like and which compels their aid, rather than by any direct communication as of person with person.
As already said of the Yurok, the idea that the shaman owns guardian spirits and operates through communications with them, is feebly developed and expressed only indirectly.
Shamans work primarily through “pains”; and these, although alive, are material objects.
A true “bear doctor,” as the Yuki and Yokuts know him, is therefore an impossibility among the Hupa.
Finally, it is no doubt significant in this connection that the professional shaman in the northwest is normally a woman, the kitdonghoi or uma'a more often a man.

The Hupa distinguished the tintachinwunawa, the dancing or singing doctor, who diagnoses by clairvoyance or dream, and the kitetau or sucking doctor, who removes the disease object.
Often the same shaman performed both operations, but there were dancing doctors who never attempted to extract a “pain.”
This differentiation of function has been reported from groups in several other parts of northern California.
The dancing doctor sometimes used a deer-hoof rattle.

Illness is also treated by kimauchitlchwe, people who know formulas that they have been taught by an older relative.
In connection with such a recitation an herb is invariably employed, although almost always in such a minute quantity or so indirectly or externally applied that its physiological effect must be insignificant.
Pregnancy and childbirth were always so treated, but of actual diseases apparently only a few, of chronic and annoying rather than alarming character.